VIDEO-ASSISTED THORACOSCOPIC CLOSURE OF POSTPNEUMONECTOMY BRONCHOPLEURAL FISTULAS

Despite improved surgical techniques and advances in medical-surgical treatment, postpneumonectomy bronchopleural fistulas remain an importa nt cause of morbidity and a therapeutic challenge. Video-assisted thor acoscopic closure of these fistulas reinforced by transposition of bul ky chest wall muscles or omentum to obliterate the residual space may lessen risks and complications of repeated thoracotomy in these often frail, debilitated, and compromised patients. We report our initial ex perience with video-assisted thoracoscopic debridement of the empyema cavity and closure of the postpneumonectomy bronchopleural fistula by transposing an entire pectoralis major muscle in one patient and by tr ansposing a pedicled omentum in another patient.